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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Right and Transverse Colonic Multi-Visceral Resections for Locally Advanced Cancers-a Single-Center Experience
Joseph Sebastian1, Mohamed Boshnaq1,2, Mohanraj Harilingam1
11Department of General Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, Kent CT9 4AN UK.
Indian Journal of Surgical Oncology
|June 12, 2018
Summary
Multi-visceral resections for locally advanced right-sided and transverse colon cancers are feasible, achieving good outcomes even in district general hospitals. Adequate training and multidisciplinary team support are crucial for success.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Colorectal Cancer
Background:
- Locally advanced colorectal tumors represent 5-22% of presentations.
- Curative resection (R0) often necessitates multi-visceral resection.
- Right-sided and transverse colon cancers frequently present as locally advanced.
Purpose of the Study:
- To present surgical experience with en bloc resections for locally advanced right and transverse colonic cancers.
- To evaluate the outcomes of these complex resections.
- To assess feasibility in a district general hospital setting.
Main Methods:
- Retrospective review of a prospective database (February 2008 - December 2014).
- Analysis of case notes, operative findings, histopathology, and follow-up records.
- Inclusion of 23 patients undergoing en bloc multi-visceral resections.
Main Results:
- 47% of patients had more than one organ resected.
- 78.3% achieved R0 resection, with 17.4% R1.
- 5-year survival was 65%, with 12-month disease-free survival at 90%.
Conclusions:
- Multi-visceral resections for locally advanced right/transverse colon cancer can be safely performed in district general hospitals.
- Multidisciplinary team (MDM) involvement, training, and experience are vital for optimal outcomes.
- These complex resections can lead to acceptable oncological results, even when performed by senior trainees under supervision.
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